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venetoclax (VEN) and Azacitidine (AZA) combination have shown improved survival and excellent responses in patients with untreated Acute myeloid leukemia (AML). However, frequent dose reduction (or discontinuation) occurred due to therapy-related toxicity and may limit triplet combination tolerance. This study retrospectively analyzed the characteristics and outcomes of newly diagnosed AML patients who received 100mg VEN for 14 days combined with AZA at our institution. Overall, 36 patients were enrolled, the median age at diagnosis was 64 years; after a median follow-up of 15(range 4–29) months, median overall survival (OS) and progression-free survival (PFS) for the total cohort were 17 (4–29) months and 12 (1–28) months, and for patients achieving composite complete remission (CRc) were not reached. Overall response rate (ORR) was 69.4% and CRc rate were 66.7% for the total cohort. Subgroup analysis revealed that NPM1 mutations and FAB-M5 were associated higher response rates, while adverse ELN risk group predicted inferior response. ASXL1, NPM1 and IDH1/2 mutation was statistically significant impact the PFS duration. The most common adverse events were hematological, with grade 3 or 4 neutropenia, thrombocytopenia, and anemia reported in 36%, 25%, 44% of patients, respectively. In summary, the VEN combination regimen remains effective for newly diagnosed AML in the real world despite VEN dose reductions.

We performed a double-blind, double-dummy controlled study to compare the efficacy between recombinant human thrombopoietin (rhTPO) and eltrombopag in rapidly increasing the platelet counts in Chinese patients with immune thrombocytopenia (ITP). A total of 96 patients diagnosed with ITP for ≥6 months who had baseline platelet counts of

Since December 2019, when coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan and then spread worldwide, there have been ...

Vascular endothelial growth factor (VEGF) plays an important role in atherosclerosis, and the detection of VEGF is critical for the prevention, monitoring, and diagnosis of cardiovascular diseases. Here, a novel "signal on-off-super on" sandwich-type aptamer sensor with a triple signal amplification strategy was developed for the first time. Based on the capture aptamer was labeled with methylene blue (MB) on the internal bases, clustered regularly interspaced short palindromic repeats (CRISPR)-Cas12a-coupled voltage enrichment was used to amplify the electrochemical signal. To improve the analytical performance of the aptamer sensor, gold nanoparticles@Ti

Haploidentical stem cell transplantation (HSCT) has become an alternative treatment option for patients with aplastic anemia (AA) without matched sibling donors or matched unrelated donors. Recently, post-transplantation cyclophosphamide (PTCy) and granulocyte colony-stimulating factor (G-CSF)/antithymocyte globulin (ATG) regimens have become the most common protocols used worldwide. In this retrospective study, we retrospectively reviewed and analyzed the clinical data of 130 AA patients who underwent haploidentical HSCT and received the modified PTCy (mPTCy) regimen (n = 55) or G-CSF/ATG regimen (n = 75) between January 2013 and June 2021 across 7 transplantation centers. Neutrophil engraftment was successful in all patients within 30 days in the G-CSF/ATG group. The cumulative neutrophil engraftment rate in the mPTCy group was 96.36% (95% confidence interval [CI], 94.57 to 97.57; P = .010). The median time to neutrophil engraftment in the G-CSF/ATG group was 10 days (range, 7 to 28 days), which was more rapid than that observed in the mPTCy group (P.001). There was no significant difference in the incidence of graft-versus-host disease (GVHD) between the 2 groups. The cumulative incidence of grade II-IV acute GVHD was 18.40% (95% CI, 4.27% to 40.31%) in the mPTCy group and 19.32% (95% CI, 5.86% to 38.58%) in the G-CSF/ATG group, whereas the cumulative incidence of grade III-IV acute GVHD was 7.31% (95% CI, .09% to 37.48%) in the mPTCy group and 7.57% (95% CI, .20 to 34.19) in the G-CSF/ATG group. Similarly, there were no significant between-group differences in overall survival (OS), failure-free survival (FFS), and GVHD-free relapse-free survival (GRFS). The 2-year OS, FFS, and GRFS rates were 95.91% (95% CI, 84.59% to 98.96%), 92.25% (95% CI, 80.59% to 97.03%), and 86.68% (95% CI, 73.98% to 93.44%), respectively, in the mPTCy group and 86.67% (95% CI, 76.64% to 92.59%), 81.28% (95% CI, 70.45% to 88.46%), and 77.20% (95% CI, 65.89% to 85.16%), respectively, in the G-CSF/ATG group. Transplantation-related mortality (TRM) was significantly higher in the G-CSG/ATG group than in the mPTCy group (13.33% versus 1.96%; P = .022). In multivariate analysis, the use of a female donor, a higher Hematopoietic Cell Transplantation Comorbidity Index, and grade III-IV acute GVHD were associated with worse survival outcomes. The mPTCy and G-CSF/ATG regimens led to similar outcomes in AA patients, but quicker engraftment was observed with the ATG/G-CSF regimen, and a lower incidence of TRM was observed with the mPTCy regimen.

We studied by questionnaire 530 subjects with chronic myeloid leukaemia (CML) in Hubei Province during the recent SARS-CoV-2 epidemic. Five developed confirmed (N = 4) or probable COVID-19 (N = 1). Prevalence of COVID-19 in our subjects, 0.9% (95% Confidence Interval, 0.1, 1.8%) was ninefold higher than 0.1% (0, 0.12%) reported in normals but lower than 10% (6, 17%) reported in hospitalised persons with other haematological cancers or normal health-care providers, 7% (4, 12%). Co-variates associated with an increased risk of developing COVID-19 amongst persons with CML were exposure to someone infected with SARS-CoV-2 (P = 0.037), no complete haematologic response (P = 0.003) and co-morbidity(ies) (P = 0.024). There was also an increased risk of developing COVID-19 in subjects in advanced phase CML (P = 0.004) even when they achieved a complete cytogenetic response or major molecular response at the time of exposure to SARS-CoV-2. 1 of 21 subjects receiving 3rd generation tyrosine kinase-inhibitor (TKI) developed COVID-19 versus 3 of 346 subjects receiving imatinib versus 0 of 162 subjects receiving 2nd generation TKIs (P = 0.096). Other co-variates such as age and TKI-therapy duration were not significantly associated with an increased risk of developing COVID-19. Persons with these risk factors may benefit from increased surveillance of SARS-CoV-2 infection and possible protective isolation.

Objective Multiple myeloma (MM) patients with bone destruction are difficult to restore, so it is of great clinical significance to further explore the factors affecting MM bone destruction. Methods and results This study retrospectively analyzed 419 cases with MM. Multiple linear regression analysis showed that those MM patients with a higher concentration of Ca2+ in serum, higher positive rate of CD138 immuno-phenotype and advanced in stage with 13q34 deletion in cytogenetics would be more prone to bone destruction, while total bile acid (TBA) and kappa chain isotope negatively correlated with bone destruction in MM patients. The Kaplan-Meier analysis indicated that Ca2+, serum β2-microglobulin (β2-MG), hemoglobin (HGB), creatinine (CREA), uric acid (UA) and age correlated with the survival of bone destruction in MM patients. Cox regression analysis further showed that the independent prognostic factors of β2-MG and CREA had a higher risk for early mortality in bone destruction patients. Moreover, an index was calculated based on β2-MG and globulin (GLB) to white blood cell (WBC) ratio to predict the poor survival of bone destruction patients. Conclusion We provide a novel marker to predict the prognosis of myeloma patients using routine examination method instead of bone marrow aspiration, and provide a reference for clinical evaluation.

BACKGROUND: This study sought to analyze non-targeted plasma metabolites in patients with atherosclerosis (AS). METHODS: The plasma of patients with AS (the patient group) and the plasma of age-matched and gender-matched healthy individuals (the control group) at the Taihe Hospital was collected. One hundred patients were included in the study (60 in the patient group and 40 in the control group). Fasting venous plasma was collected in the morning. The metabolites in the plasma were examined by liquid chromatography-mass spectrometry (LC-MS). An unsupervised principal component analysis (PCA) was conducted to observe the overall distribution of each sample and the stability of the analysis process. Next, a supervised partial least squares-discriminant analysis (PLS-DA) and an orthogonal partial least squares-discriminant analysis (OPLS-DA) were conducted to examine the overall differences among the metabolic profiles of the groups and identify different metabolites in the groups. Pathway enrichment was analyzed using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. RESULTS: In total, 1,126 different metabolites were detected in the patient and control groups. Compared to the control group, 411 species decreased, and 715 species increased in the patient group. There were 61 different metabolites with a variable weight in the projection (VIP) >1 and a P1; P

Infection with SARS-CoV-2, the cause of coronavirus infectious disease-19 (COVID-19), has caused a pandemic with >850,000 cases worldwide and increasing. Several studies report outcomes of COVID-19 in predominately well persons. There are also some data on COVID-19 in persons with predominately solid cancer but controversy whether these persons have the same outcomes. We conducted a cohort study at two centres in Wuhan, China, of 128 hospitalised subjects with haematological cancers, 13 (10%) of whom developed COVID-19. We also studied 226 health care providers, 16 of whom developed COVID-19 and 11 of whom were hospitalised. Co-variates were compared with the 115 subjects with haematological cancers without COVID-19 and with 11 hospitalised health care providers with COVID-19. There were no significant differences in baseline co-variates between subjects with haematological cancers developing or not developing COVID-19. Case rates for COVID-19 in hospitalised subjects with haematological cancers was 10% (95% Confidence Interval [CI], 6, 17%) compared with 7% (4, 12%; P = 0.322) in health care providers. However, the 13 subjects with haematological cancers had more severe COVID-19 and more deaths compared with hospitalised health care providers with COVID-19. Case fatality rates were 62% (32, 85%) and 0 (0, 32%; P = 0.002). Hospitalised persons with haematological cancers have a similar case rate of COVID-19 compared with normal health care providers but have more severe disease and a higher case fatality rate. Because we were unable to identify specific risk factors for COVID-19 in hospitalised persons with haematological cancers, we suggest increased surveillance and possible protective isolation.

Background Since late December 2019, the outbreak of the novel coronavirus disease, COVID-19, that began in Wuhan, has become endemic in China and more than 100 countries and regions in the world. So far, there is rare data on the prevalence of COVID-19 in patients with chronic myelogenous leukemia (CML). We aimed to describe the clinical course, outcomes of CML patients with COVID-19 and prevalence of COVID-19 in CML patients. Methods In this multi-center survey, cross-sectional survey, observational study, the clinical data of CML patients with COVID-19 in each center were collected. Simultaneously, an online survey was conducted for information about the CML patients under the management at each center by asking the CML patients to complete a questionnaire,from February 15, 2020 to February 21, 2020. The questionnaire includes demographic data, place of residence, smoking status, CML diagnosis and treatment, comorbidities, combined medications, epidemiological history, symptoms(fever, cough, shortness of breath, etc) during the epidemic. Additional clinical data was collected on respondents suspected or confirmed to have COVID-19. We described and analyzed the prevalence of COVID-19 in CML patients, and focus on the clinical characteristics and outcomes of COVID-19 patients. Data were compared between the CML patients with optimal response and those with non-optimal response. The primary outcome was prevalence of COVID-19 in CML patients, as of Feb 21, 2020. Secondary outcomes included the history of epidemiology of CML patients, the clinical characteristics and outcomes of CML patients with COVID-19 . Findings Of 392 respondents, 223( 56.9%) were males, and 240( 61.2%) were 50 years or younger. Only 10 patients took drugs irregularly due to the influence of the epidemic because of traffic control, pharmacies unable to operate normally, etc. In the history of epidemiology, there were 4 patients with definite contact with COVID-19, of which 3 were remote contact and 1 was close contact. 12 respondents had fever, cough or shortness of breath during the epidemic, 1 case (common type) was confirmed with COVID-19 and cured after treatment. 1 patient was clinically diagnosed and succumbed. 1 of 299 (0.3%) patients with an optimal response was diagnosed with COVID-19. Of the 50 patients who failed to respond to CML treatment or had a poor response, 1 patient (2%) had a clinical diagnosis of COVID-19. Interpretation While the 392 CML respondents required regular referrals to hospitals, they did not have much contact with COVID-19 patients during the outbreak. Patients who failed to achieved an optimal response to CML therapy appear more likely to have a symptomatic infection with SARS-CoV-2. Older patients with comorbidities are at increased risk of death. Dan-Yu Wang, Jing-Ming Guo, Zhuang-Zhi Yang Co first author Dan-Yu Wang,Department of Hematology, Huazhong University of Science and Technology Union Shenzhen Hospital, Guangdong Medical University, Shenzhen Guangdong, China,E-mail: 15818662864@139.com Jing-Ming Guo, Department of Hematology,Yi Chang Central Peoples Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang Hubei, China,E-mail:gjm425@163.com Zhuang-Zhi Yang, Department of Hematology,Suizhou Central Hospital, Suizhou Hubei, China,E-mail:yzhzh88@163.com Correspondence author: Guo-Lin Yuan, MD, Department of Hematology, Xiangyang Central Hospital, The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang Hubei, China. E-mail: yuanguo1973@163.com Li Meng, MD, Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology,Wuhan Hubei, China. E-mail: mengli@tjh.tjmu.edu.cn Wei-Ming Li, MD, Department of Hematology, Union hospital, Tongji Medical college, Huazhong University of science and Technology, Wuhan Hubei, China. E-mail: lee937@126.com

Background: The severe acute respiratory coronavirus 2 (SARS-CoV-2) has caused a pandemic, but data about hospital-associated infection are scarce We aimed to

Background: 2019 novel coronavirus disease (COVID-19) has caused a pandemic, but data about hospital-associated infection in haematological units are yet to kno

Background: Since late December 2019, the outbreak of the novel coronavirus disease, COVID-19, that began in Wuhan, has become endemic in China and more than 100 countries and regions in the world. There is no report about the prevalence of COVID-19 in CML patients untill now. We aimed to describe the clinical course, outcomes of CML patients with COVID-19 and prevalence of COVID-19 in CML patients. Methods: In this multi-center survey, cross-sectional survey, observational study, the clinical data of CML patients with COVID-19 in each center were collected. Simultaneously, an online survey was conducted for information about the CML patients under the management at each center by asking the CML patients to complete a questionnaire,from February 15, 2020 to February 21, 2020. The questionnaire includes demographic data, place of residence, smoking status, CML diagnosis and treatment, comorbidities, combined medications, epidemiological history, symptoms (fever, cough, shortness of breath, etc) during the epidemic. Additional clinical data was collected on respondents suspected or confirmed to have COVID-19. We described and analyzed the prevalence of COVID-19 in CML patients, and focus on the clinical characteristics and outcomes of COVID-19 patients. Data were compared between the CML patients with optimal response and those with non-optimal response. The primary outcome was prevalence of COVID-19 in CML patients, as of Feb 21, 2020. Secondary outcomes included the history of epidemiology of CML patients, the clinical characteristics and outcomes of CML patients with COVID-19. Findings: Of 392 respondents, 223(56.9%) were males, and 240(61.2%) were 50 years or younger. Only 10 patients took drugs irregularly due to the influence of the epidemic because of traffic control, pharmacies unable to operate normally, etc. In the history of epidemiology, there were 4 patients with definite contact with COVID-19, of which 3 were remote contact and 1 was close contact. 12 respondents had fever, cough or shortness of breath during the epidemic, 1 case (common type) was confirmed with COVID-19 and cured after treatment. 1 patient was clinically diagnosed and succumbed. 1 of 299 (0.3%) patients with an optimal response was diagnosed with COVID-19. Of the 50 patients who failed to respond to CML treatment or had a poor response, 1 patient (2%) had a clinical diagnosis of COVID-19. Interpretation: While the 392 CML respondents required regular referrals to hospitals, they did not have much contact with COVID-19 patients during the outbreak. Patients who failed to achieved an optimal response to CML therapy appear more likely to have a symptomatic infection with SARS-CoV-2. Older patients with comorbidities are at increased risk of death. Funding Statement: This work was supported by grants from the National Natural Science Foundation of China(NSFC)(81873440&81700142). Declaration of Interests: All participants have no competing interests. Ethics Approval Statement: The investigation was approved by the ethics committee of the Union hospital of the Tongji Medical College, which is part of the Huazhong University of Science and Technology.

The neuropeptide secretoneurin (SN) plays protective roles in myocardial ischemia. In the present study, the effect of SN in cardiac hypertrophy was investigated. We observed that, in isoproterenol (ISO) treatment induced cardiac or cardiomyocytes hypertrophy, a marked increase in the expression of endogenous SN in mouse plasma, myocardium and primary-cultured cardiomyocytes occurs. In hypertrophic mice, the heart size, heart weight/body weight (HW/BW) ratio, cardiomyocyte size, and atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) expression were significantly higher than those in controls but were effectively suppressed by SN gene therapy. Similarly, the protective effects of SN were also observed in cultured cardiomyocytes following ISO treatment. SN significantly increased the activity of catalase and superoxide dismutase (SOD) in parallel with the decrease in reactive oxygen species levels in cardiomyocytes. We observed that SN evoked the activation of all of the AMPK, P38/MAPK and ERK/MAPK pathways in cardiomyocytes, but pretreatment with only AMPK inhibitor (compound C) and ERK1/2/MAPK inhibitor (PD98059) counteracted the protective effects of SN against cardiomyocyte hypertrophy and the suppressive effects of SN on oxidant stress in cardiomyocytes. These results indicated that endogenous SN is induced in hypertrophic cardiomyocytes, and may play a protective role in the pathogenesis of cardiac hypertrophy. These results suggest that exogenous SN supplementation protects the cardiac hypertrophy induced by ISO treatment through the activation of AMPK and ERK/MAPK pathways, thus upregulating antioxidants and suppressing oxidative stress.

Background: The purpose of this study is to compare efficacy and safety of patients with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP) treated with frontline dasatinib 70 mg/day with those who received standard-dose dasatinib 100 mg/day. Method: From July 2019 to July 2021, 81 patients with newly diagnosed CML-CP were enrolled across 11 centers. All of the patients were randomly treated with dasatinib 70 mg/day (N=43) or standard-dose dasatinib 100 mg/day (N=38). Results: Among 81 enrolled patients, 16 patients were off study at different times for different reasons.All patients achieved hematological remission after 3 months of treatment, and the best response rates were 84.00% (21/25) and 88.89% (24/27) for 70mg/d and 100mg/d groups (P>0.05).At 6 months, the best response, complete cytogenetic response (CCyR) and major molecular response (MMR) rate were 94.44% vs 92.86% (P > 0.05), 94.44% vs 92.86% (P > 0.05) and 55.56% vs 71.43% (P > 0.05), respectively.At 9 months, the rates of CCyR and MMR were 90.91% vs 88.89% (P > 0.05) and 66.67% vs 72.73% (P > 0.05);CCyR and MMR by 12 months, respectively, were 90.91% vs 100.00% (P > 0.05), 81.82% vs 80.00% (P > 0.05).The adverse events (AEs) of the two groups were mild, and there was no significant difference (P > 0.05).The most common grade ≥3 hematological AEs in 70 mg/d group were leukopenia (1/43), neutropenia (1/43) and anemia (2/43), and In 100mg/d group were leukopenia (4/38), neutropenia (6/38), anemia (3/38) and thrombocytopenia (3/38). Conclusions: Our study suggests that patients with newly diagnosed CML-CP treated with dasatinib 70 mg/day or 100 mg/day, there is no significant difference in efficacy and safety. Decreasing the dose of dasatinib can ensure the efficacy of patients, while reducing the economic burden of patients and increasing patient compliance. Disclosures No relevant conflicts of interest to declare.

The intercellular communication between leukemia cells and bone marrow mesenchymal stem cells (BM-MSCs) plays more important role in chronic myeloid leukemia (CML) than we previously understood. Recently, we found that microvesicles released from human leukemia cell line K562 (K562-MVs) containing BCR-ABL1 mRNA malignantly transformed normal hematopoietic transplants. Here, we investigated whether K562-MVs contribute to the transformation of human bone marrow mesenchymal stem cells (BM-MSCs). We showed that K562-MVs could be integrated into co-cultured normal BM-MSCs and dose-dependently enhanced the proliferation of BM-MSCs. Meanwhile, K562-MVs (400 ng/mL) significantly increased the expression of BCR-ABL1 in these BM-MSCs, accompanied by the enhanced secretion of TGF-β1. These BM-MSCs in turn could trigger the TGF-β1-dependent proliferation of K562 cells. Moreover, we confirmed the presence of BCR-ABL1 in circulating MVs from 11 CML patients. Compared to the normal BM-MSCs, the BM-MSCs from CML patients more effectively increased the BCR-ABL1 expression and TGF-β1 secretion in K562 cells as well as the proliferation of K562 cells. Our findings enrich the mechanisms involved in the interaction between leukemia cells and BM-MSCs and provide novel ways to monitor minimal residual disease and worthwhile approaches to treat CML.

Purpose Half of the chronic myeloid leukemia (CML) patients with sustained deep molecular response suffer from relapse after discontinuation mainly because tyrosine kinase inhibitors (TKIs) cannot eradicate leukemia stem cells (LSCs). In addition, tumor necrosis factor α (TNF-α) is highly detected in CML patients. Our aim was to explore whether TNF-α is a potential target for LSC elimination. Materials and methods We applied a CRISPR/Cas9 gene editing technique, colony-forming cell assay, subcutaneous tumor models, miRNA-seq and liquid chromatography-mass spectroscopy (LC-MS) on metabonomics to explore the feasibility and mechanism of TNF-α as a new therapeutic target for CML. Results We demonstrated that TNF-α knockout remarkably decreased the proliferative, colony-forming and in vivo tumorigenesis capacities of the CML K562 cell line. The apoptosis was increased when TNF-α knockout cells were cultured with imatinib. The mechanisms involved in the abovementioned phenomena were that TNF-α knockout inhibited the citrate cycle and increased starch, sucrose, amino sugar and nucleotide sugar metabolism. In addition, differentially expressed miRNAs between TNF-α knockout and control cells were involved in the cell cycle, CML, P13K-Akt and pathways in cancer. Conclusion We identified that TNF-α may serve as a new target therapy for CML and described the metabolic pathways associated with TNF-α in CML cells for the first time.

Na Shen,1,* Songya Liu,2,* Jieke Cui,3 Qing Li,4 Yong You,1 Zhaodong Zhong,1 Fanjun Cheng,1 An-Yuan Guo,5 Ping Zou,1 Guolin Yuan,6 Xiaojian Zhu2 1Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; 2Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; 3Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; 4Department of Hematology, Wuhan No 1 Hospital, Wuhan 430022, China; 5Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan 430074, China; 6Department of Hematology, Xiangyang Central Hospital, The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang 441000, China *These authors contributed equally to this work Purpose: Half of the chronic myeloid leukemia (CML) patients with sustained deep molecular response suffer from relapse after discontinuation mainly because tyrosine kinase inhibitors (TKIs) cannot eradicate leukemia stem cells (LSCs). In addition, tumor necrosis factor α (TNF-α) is highly detected in CML patients. Our aim was to explore whether TNF-α is a potential target for LSC elimination.Materials and methods: We applied a CRISPR/Cas9 gene editing technique, colony-forming cell assay, subcutaneous tumor models, miRNA-seq and liquid chromatography-mass spectroscopy (LC-MS) on metabonomics to explore the feasibility and mechanism of TNF-α as a new therapeutic target for CML.Results: We demonstrated that TNF-α knockout remarkably decreased the proliferative, colony-forming and invivo tumorigenesis capacities of the CML K562 cell line. The apoptosis was increased when TNF-α knockout cells were cultured with imatinib. The mechanisms involved in the abovementioned phenomena were that TNF-α knockout inhibited the citrate cycle and increased starch, sucrose, amino sugar and nucleotide sugar metabolism. In addition, differentially expressed miRNAs between TNF-α knockout and control cells were involved in the cell cycle, CML, P13K-Akt and pathways in cancer.Conclusion: We identified that TNF-α may serve as a new target therapy for CML and described the metabolic pathways associated with TNF-α in CML cells for the first time. Keywords: chronic myeloid leukemia, tumor necrosis factor α, CRISPR/Cas9 gene editing, tumorigenesis, metabolism profile

Supplemental Digital Content is available in the text, To assess treatment response and overall survival (OS) in refractory or relapsed acute myeloid leukemia (R/R AML) patients treated by different common salvage chemotherapy regimens. Medical records data from 142 R/R AML patients were reviewed in this retrospective study. Patients were treated with regimens based on the following drugs: cytarabine, granulocyte colony-stimulating factor (G-CSF), and fludarabine (FLAG) (n = 46); cytarabine and G-CSF in addition to aclarubicin or daunorubicin (CAG/DAG) (n = 30); cytarabine, G-CSF, and cladribine (CLAG) (n = 27); cytarabine, etoposide, and mitoxantrone (MEA) (n = 17); cytarabine plus idarubicin, daunorubicin, or mitoxantrone (IA/DA/MA) (n = 12); and homoharringtonine, cytarabine, and aclarubicin or daunorubicin (HAA/HAD) (n = 10). A total of 43 (35.2%) patients achieved complete remission (CR), 60 (49.2%) patients achieved overall remission rate (ORR), and 18 (14.8%) patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT) after CR. Median OS was 8.0 (95% CI 6.6–9.4) months with a 1-year OS rate of (29.9 ± 3.9)% and 3-year OS rate of (11.1 ± 3.6)%. No difference of CR (P = .621), ORR (P = .385), and allo-HSCT (P = .537) achievement was observed among different chemotherapy regimens. Interestingly, we observed that the CLAG-based regimen did not affect CR (P = .165), while it achieved a numerically higher ORR (P = .093) and was an independent factor for prolonged OS (P = .016). No other regimens were determined to be correlated with CR, ORR, or OS. FLAG-, CAG/DAG-, CLAG-, MEA-, IA/DA/MA- and HAA/HAD-based regimens were found to achieve similar CR rates, while the CLAG-based regimen achieved numerically higher ORR rates and significant favorable OS. Therefore, CLAG-based regimens should be a prioritized treatment option for R/R AML patients.

α2,3-Sialylated glycans (α2,3-sial-Gs) are crucial molecular targets for cancer diagnosis and clinical research. We describe a biosensor for detecting α2,3-sial-Gs that is based on the specific recognition by the Maackia amurensis lectin (MAL). A glassy carbon electrode was modified with carboxy-modified MWCNTs and a polyamidoamine dendrimer (PAMAM). The PAMAM is highly branched and contains many amino groups. MAL was immobilized on the modified electrode to create a sensor capable of detecting α2,3-sial-Gs (at a working voltage of 0.2 V vs. SCE) in the 10 fg⋅mL−1 to 50 ng⋅mL−1 concentration range and with a detection limit as low as 3 fg⋅mL−1 (at an S/N ratio of 3). This approach may pave the way to detection schemes for other proteins and glycans if appropriate affinity binding pairs are available.

The aberrant expression of Vangl1 is highly correlated with dysontogenesis, especially for neural tube defects. Therefore, the ultrasensitive detection of Vangl1 would provide a new approach for the specific early diagnostics in dysembryoplasia. However, no quantitative detection method is currently available. Herein, we describe the development of a new approach to fill this assay gap. We utilized C60-templated AuPt bimetallic nanoclusters for signal amplification because the promising C60 nanomaterial provides a large surface area for the in site reduction of bimetallic nanocomposites as well as excellent conductivity. To further amplify the electrochemical signal, reduced graphene oxide-tetraethylene pentamine (rGO-TEPA) and a derivative of 3,4,9,10-perylenetetracarboxylicdianhydride (PTC-NH2) were selected for modification of the electrode to provide more amino groups for the immobilization of antibodies and to enhance the conductivity. The electrochemical signal was primarily derived from the catalysis of H2O2 by C60–AuPt. Chronoamperometry was applied to record the electrochemical signals. Under optimal conditions, the prepared immunosensor exhibited a wide linear range from 0.1 pg mL−1 to 450 pg mL−1 and a low detection limit of 0.03 pg mL−1. Moreover, the proposed method exhibited good stability and recovery, suggesting its potential for use in clinical research.

In this work, a novel label-free biosensor was designed for the sensitive and selective determination of Neu5Acα(2-6)Gal β MP Glycoside using AuPt-PPy(polypyrrole) conductive nanocomposite film as the sensor platform. The introduced AuPt-PPy nanocomposite provided a large surface area for the immobilization of Sambucus nigra agglutinis (SNA) through a coupling agent for specifically recognizing analytes and exhibited high electrocatalytic activity toward the reduction of hydrogen peroxide (H2O2) as an analytical signal. Subsequently, to block the non-specific sites of the modified electrode, GOx was employed instead of the usual sealers. Most importantly, in the presence of glucose, these localized GOx further enhanced the electrochemical signal, which was achieved by the efficient catalysis of glucose. This study is the first that demonstrates the specific detection of Neu5Acα(2-6)Gal β MP Glycoside using AuPt-PPy as the electrocatalytic. Under optimal conditions, the electrochemical biosensor exhibited a wide linear range of 0.01 pgmL(-1)-800 ngmL(-1) with a low detection limit of 0.003 pgmL(-1) (S/N=3), due to the affinity between SNA and Neu5Acα(2-6)Gal β MP Glycoside. Therefore, the co-catalysis signal amplification approach has considerable potential in clinical applications and is suitable for the quantification of other biomarkers.

Sialylated glycans are crucial molecular targets for cancer diagnosis and clinical research. α2,3-Sialylated glycans and α2,6-sialylated glycans are the predominant sialic acids found in nature. Different expression of the quantity of glycans can result in development of different disease. However, there are no ideal methods for discriminating α2,3-sialylated glycans and α2,6-sialylated glycans. In this work, a multi-purpose biosensor is fabricated for sensitive detection of α2,3-sialylated glycans and α2,6-sialylated glycans. To improve the sensitivity of the biosensor, p-MWCNTs were integrated with PAMAM, as PAMAM has highly branched and abundant amino groups, providing a large available surface area for linking with other substances. To achieve distinguishable recognition, Maackia amurensis lectin (MAL) and Sambucus nigra agglutinin (SNA) were included. To facilitate the lectin fixation, PDITC, a kind of green homobifunctional cross-linker, was selected. Under optimized detection conditions, the linear range of detection for α2,3-sialylated glycans is 10 fg mL−1 to 50 ng mL−1 with a lower detection limit of 3 fg mL−1, and the linear range of detection for α2,6-sialylated glycans is 10 fg mL−1 to 50 ng mL−1 with a detection limit of 3 fg mL−1. This work not only provides a method for distinguishing detection of α2,3-sialylated glycans and α2,6-sialylated glycans, but also provides a reference for future clinical testing.

Dasatinib is a second-generation tyrosine kinase inhibitor (TKI) and it could be used as a second-line treatment for patients with chronic myeloid leukemia (CML). Yinishu, a generic dasatinib made in China, was approved by the China Food and Drug Administration in 2013 and it costs much less than the patented dasatinib SPRYCEL. The present study aimed to examine the efficacy and safety of Yinishu as a second-line treatment for CML by comparing the baseline clinical characteristics, rates of adverse events and efficacy between Yinishu and SPRYCEL groups. The results showed that there were no significant differences in the rates of optimal response between Yinishu and SPRYCEL for patients who started second-line treatment because of treatment failure. For patients who started second-line treatment because of intolerance of first-line treatment, their levels of BCR-ABL1/ABL1 on the international scale (BCR-ABLIS) was maintained very low throughout the course of Yinishu treatment. Drug-related adverse events occurred with the same frequency in these two groups. It was confirmed that Yinishu was effective and safe as a secondline treatment for CML patients. Yinishu may be more suitable for patients who are economically unable to pay for the patented dasatinib SPRYCEL.

Background: As a hallmark driver of multiple myeloma (MM), MM bone disease (MBD) is unique in that it is characterized by severely impaired osteoblast activity resulting from blocked osteogenesis in bone marrow-derived mesenchymal stem cells (BM-MSCs). The mechanisms underlying this preferential blockade are incompletely understood. Methods: miRNA expression of MM cell-derived extracellular vesicles (MM-EVs) was detected by RNA sequencing. MM-EVs impaired osteogenesis and exacerbated MBD were in vitro and in vivo validated by histochemical staining, qPCR and micro-CT. We additionally examined the correlation between CD138+ circulating EVs (cirEVs) count and bone lesion in de novo MM patients. Results: Here, by sequencing and bioinformatics analysis, we found that MM-EVs were enriched in various molecules negatively regulating osteogenesis. We experimentally verified that MM-EVs inhibited BM-MSC osteogenesis, induced elevated expression of miR-103a-3p inhibiting osteogenesis in BM-MSCs, and increased cell viability and interleukin-6 secretion in MM cells. In a mouse model, MM-EVs that were injected into the marrow space of the left tibia led to impaired osteogenesis and exacerbated MBD and MM progression. Furthermore, the levels of CD138+ cirEVs in the peripheral blood were positively correlated with the number of MM bone lesions in MM patients. Conclusions: These findings suggest that MM-EVs play a pivotal role in the development of severely impaired osteoblast activity, which represents a novel biomarker for the precise diagnosis of MBD and a compelling rationale for exploring MM-EVs as a therapeutic target.

Background/Aims: The aim of this work was to investigate the efficacy and predictive factors of CLAG treatment in refractory or relapsed (R/R) acute myeloid leukemia (AML) patients. Methods: Sixty-seven R/R AML patients were enrolled in this prospective cohort study and treated by a CLAG regimen: 5 mg/m2/day cladribine (days 1–5), 2 g/m2/day cytarabine (days 1–5), and 300 μg/day filgrastim (days 0–5). The median follow-up duration was 10 months. Results: A total of 57 out of 67 patients were evaluable for remission after CLAG therapy, of whom 57.9% achieved a complete remission (CR) and the overall remission rate was 77.2%. The median overall survival (OS) was 10.0 months, with a 1-year OS of 40.3 ± 6.0% and 3-year OS of 16.7 ± 5.7%. CR at first induction after the initial diagnosis was associated with a favorable CR. Age above 60 years, high risk stratification, second or higher salvage therapy, and bone marrow (BM) blasts ≥42.1% were correlated with an unfavorable CR. Secondary disease, age ≥60 years, high risk stratification, and second or higher salvage therapy were associated with worse OS. Patients developed thrombocytopenia (41, 61%), febrile neutropenia (37, 55%), leukopenia (33, 49%), neutropenia (18, 27%), and anemia (9, 13%). Conclusion: CLAG was effective and well tolerated for R/R AML. BM blasts ≥42.1%, age ≥60 years, high risk stratification, and second or higher salvage therapy were independent factors for a poor prognosis.

We report on a highly sensitive electrochemical immunoassay for the serum inflammation marker amyloid A (SAA). It is making use of a glassy carbon electrode that was modified with carboxy-endcapped polypyrrole (PPy-α-COOH), multiwalled carbon nanotubes (MWCNTs), ionic liquid and chitosan acting as the support platform. The nanocomposite increases the sensitivity and stability of the assay. Antibody against SAA was immobilized on a monolayer surface consisting of PPy-α-COOH. The electrode material was characterized by scanning electron microscopy, transmission electron microscopy, Fourier transform infrared spectra, cyclic voltammetry, electrochemical impedance spectroscopy and differential pulse voltammetry. The calibration plot for this assay, when operated at 0.16 V (vs. SCE) and applied to spiked serum samples, is linear in the 0.001 to 900 ng mL−1 SAA concentration range, and the detection limit is as low as 0.3 pg mL−1 (at an S/N ratio of 3). The electrode is stable and highly sensitive. The detection scheme is likely to be applicable to numerous other kinds of immunoassays.

In this work, a novel, ultrasensitive electrochemical immunosensor has been fabricated for the determination of gypican-3 (GPC3) in human serum. A disposable indium tin oxide (ITO) glass array was used as the working electrode on which pyrrole-α-carboxylic acid (Py-α-COOH) was electropolymerised. This approach provided a high content of surface-confined carboxyl groups suitable for the direct covalent binding of GPC3 antibody. In the immunosensor system, the “fluorescence microscopy” technique was first used for the characterisation of carboxyl groups. Meanwhile, the electrode was characterised by scanning electron microscopy (SEM) and electrochemical impedance spectroscopy (EIS). Using GPC3 as a model analyte, the immunoassay exhibited high sensitivity, acceptable stability and reproducibility with a wide linear range from 0.9 pg mL−1 to 9 ng mL−1 and an ultra-low detection limit of 0.3 pg mL−1 (S/N = 3). The results for real sample analysis in human serum demonstrated that the newly constructed immunosensor array provided a rapid, simple and cost-efficient immunoassay with high throughput and sufficiently low detection limits for clinical applications.

The analysis of soluble CD40 ligand (sCD40L), which is present at significant levels in the blood of patients with cardiovascular disease, can reveal the severity of the disease at its early stage. However, the current biomarker detection techniques exhibit poor detection limits. To accomplish this main challenge, herein, we demonstrate an assay based on a novel modified electrochemical immunosensor for the ultrasensitive assay of sCD40L in human serum, which uses β-cyclodextrin (CD) and reduced graphene oxide-tetraethylene (rGO-TEPA) as a platform. rGO-TEPA contains a great number of amino groups and has excellent conductivity, which makes it a promising material for application in electrochemical biosensor development. To further improve the solubility and stability of rGO-TEPA, CD was selected. The CD decorated rGO-TEPA film not only improved the electron transfer but also provided more amino-groups for the immobilization of antibodies. For speeding up the immobilization of antibodies, the amine-modified electrodes were functionalized by a “green” conjugation route using a lower toxicity homobifunctional 1,4-phenylene diisothiocyanate (PDITC) linker. This is the first study that challenges electrochemical immunosensors with CD-rGO-TEPA-PDITC as a platform for the detection of biomarkers. Under optimal conditions, sCD40L could be assayed in the range of 0.25 to 50 pg mL−1 with detection limits of 83.3 fg mL−1 (S/N = 3). We demonstrate excellent specificity and show that the proposed assay accurately detects the protein of interest. The results were in agreement with an enzyme linked immunosorbent assay, suggesting that the electrochemical immunosensor may possess potential towards use in clinical applications of the proposed immunosensor.

Cytochrome P450 (CYP) epoxygenases and the metabolites epoxyeicosatrienoic acids (EETs) exert multiple biological effects in various malignancies. We have previously found EETs to be secreted by multiple myeloma (MM) cells and to be involved in MM angiogenesis, but the role of the arachidonic acid cytochrome P450 epoxygenase pathway in the proliferation and mobility of MM cells remains unknown. In the present study, we found that MM cell lines generated detectable levels of 11,12-EET/14,15-EET and that increased levels of EETs were found in the serum of MM patients compared to healthy donors. The addition of exogenous EETs induced significantly enhanced proliferation of MM cells, whereas 17-octadecynoic acid (17-ODYA), an inhibitor of the CYP epoxygenase pathway, inhibited the viability and proliferation of MM cells. Moreover, this inhibitory effect could be successfully reversed by exogenous EETs. 17-ODYA also inhibited the motility of MM cells in a time-dependent manner, with a reduction of the gelatinolytic activity and protein expression of the matrix metalloproteinases (MMP)-2 and MMP-9. These results suggest the CYP epoxygenase pathway to be involved in the proliferation and invasion of MM cells, for which 17-ODYA could be a promising therapeutic drug.

The single nucleotide polymorphism (SNP) of the vangl1 gene is highly correlated with Neural Tube Defects (NTDs), a group of severe congenital malformations. It is hindered by the lack of a quantitative detection method. We first propose the use of a DNA biosensor to detect the missense single nucleotide polymorphism (rs4839469 c.346G>A p.Ala116Thr) of the vangl1 gene in this work. Polypyrrole (PPy) and streptavidin were integrated to modify a gold electrode. We took advantage of the PPy's good biocompatibility and excellent conductivity. To further accelerate the electron transfer process at the electrode surface, polyamidoamine dendrimer-encapsulated gold nanoparticles (Au-PAMAM) were used, because Au-PAMAM possess a large number of amino groups to load capture probes (CP). Using the biotin-streptavidin system, the Au-PAMAM-CP bionanocomposite probe, which can detect the target DNA, was conjugated to the electrode surface. Under optimal conditions, the DNA biosensor exhibited a wide linear range of 0.1–100 nM with a low detection limit of 0.033 nM (S/N=3). The results suggest that this approach has the potential to be used in clinical research.

Plateletpheresis is an important therapeutic method for treatment of patients with myeloproliferative neoplasms (MPN) presenting with thrombocytosis. This study analysed the collection efficiency of plateletpheresis (CEPP) for 94 patients with thrombocytosis who underwent plateletpheresis by Fresenius COM.TEC machine, especially analysed the CEPP for enrolled patients with PLT count at 500-1000 × 109/l. The results indicated that this device could significantly decreased PLT count, and with mean CEPP of 24.23±17.42% that ranges from 3.18% to 78.46%. Further analysis shows that the PLT counts were 500-800 × 109/l for patients, which CEPP was above 42.1% with a lower pooled WBC and RBC. Paired t-test suggested that the red blood cell (RBC) counts, PLT counts, white blood cell (WBC) counts, monocyte counts and haematocrit (HCT) significantly decreased after plateletpheresis. Bivariate correlation and multiple logistic regression analysis showed that PLT count groups, hemoglobin (HGB) before apheresis were greatly correlated with CEPP. We suggest that the device is effective at reducing platelet counts with acceptable efficiency and it is available for plateletpheresis when the PLT counts about 500-800 × 109/l for patients with higher HGB pre-apheresis in female patients. Citation Format: Yanxia Jin, Guolin Yuan, Fuling Zhou. Innovative discovery of therapeutic plateletpheresis in patients with thrombocytosis using the Fresenius COM.TEC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1645.

The aberrant expression of Vangl1 is highly correlated with dysontogenesis, especially for neural tube defects. Therefore, the ultrasensitive detection of Vangl1 would provide a new approach for the specific early diagnostics in dysembryoplasia. However, no quantitative detection method is currently available. Herein, we describe the development of a new approach to fill this assay gap. We utilized C60-templated AuPt bimetallic nanoclusters for signal amplification because the promising C60 nanomaterial provides a large surface area for the in site reduction of bimetallic nanocomposites as well as excellent conductivity. To further amplify the electrochemical signal, reduced graphene oxide-tetraethylene pentamine (rGO-TEPA) and a derivative of 3,4,9,10-perylenetetracarboxylicdianhydride (PTC-NH2) were selected for modification of the electrode to provide more amino groups for the immobilization of antibodies and to enhance the conductivity. The electrochemical signal was primarily derived from the catalysis of H2O2 by C60-AuPt. Chronoamperometry was applied to record the electrochemical signals. Under optimal conditions, the prepared immunosensor exhibited a wide linear range from 0.1 pg mL(-1) to 450 pg mL(-1) and a low detection limit of 0.03 pg mL(-1). Moreover, the proposed method exhibited good stability and recovery, suggesting its potential for use in clinical research.

A simplified electrochemical multianalyte immunosensor for the simultaneous detection of high sensitivity C-reactive protein (hsCRP) and soluble CD40 ligand (sCD40L) that uses reduced graphene oxide-tetraethylene pentamine (rGO-TEPA) that directly adsorbs metal ions as labels is reported. rGO-TEPA contains a large number of amino groups and has excellent conductivity, making it an ideal template for the loading of Pb(2+) and Cu(2+), which greatly amplifies the detection signals. The signals could be directly detected in a single run through differential pulse voltammetry (DPV), and each biorecognition event produces a distinct voltammetric peak. The position and size of each peak reflects the identity and the level of the corresponding antigen. Primarily designed for an application in a sandwich-type immunoassay based on Pb(2+) and Cu(2+) labels, two main challenges are accomplished with the herein presented nanosheets: fabrication of the template and the amination process for Pb(2+) and Cu(2+) adsorption. To further improve the analytical performance of the immunosensor, Au@bovine serum albumin (BSA) nanospheres synthesized through a "green" synthesis route were used as a sensor platform, which not only provides a biocompatible microenvironment for the immobilization of antibodies but also amplifies the electrochemical signals. Under optimal conditions, hsCRP and sCD40L could be assayed in the range of 0.05 to 100 ng mL(-1) with detection limits of 16.7 and 13.1 pg mL(-1) (S/N=3), respectively. The assay results on clinical serum samples with the proposed immunosensor were in acceptable agreement with those using the standard single-analyte test of the enzyme-linked immunosorbent assay (ELISA). This novel immunosensing system provides a simple, sensitive and low-cost approach for a multianalyte immunoassay.

Microvesicles (MVs) in body fluids participate in a variety of physical and pathological processes, and are regarded as potential biomarkers for numerous diseases. Flow cytometry (FCM) is among the most frequently used techniques for MV detection. However, different handling methods unavoidably cause pre-analytical variations in the counts and sizes of MVs determined by FCM. The aim of the present study was to investigate the effect of centrifugation, storage conditions and anticoagulant on MV measurements. Blood samples were obtained from 13 healthy donors, including 4 women and 9 men. Calcein-AM staining was used to label MVs and assess the impact of pre-analytical preparation, including centrifugation, and storage conditions on MV measurements obtained using FCM. The range of factors investigated for comparison included: Platelet-free plasma (PFP) stored at -80°C for 1 or 4 weeks; MVs stored at 4°C for 3-4 days or 1 week; MVs frozen at -80°C for 1 or 4 weeks; and anticoagulants, either heparin or ethylenediaminetetraacetic acid (EDTA). No statistically significant differences in MV counts were detected between the two centrifugation speeds (16,000 and 20,500 × g) or among the three centrifugation times (15, 30 and 60 min) investigated. Similarly, no significant differences were noted in MV counts between the two anticoagulants tested (heparin and EDTA). However, the storage of PFP or MVs in heparin-anticoagulated plasma for different periods markedly affected the detected MV counts and size distribution. The counts and sizes of MVs from EDTA-anticoagulated plasma were only affected when the MVs were frozen at -80°C for 4 weeks. In conclusion, calcein-AM is able to efficiently identify MVs from plasma and may be an alternative to Annexin V for MV staining. EDTA preserves the MV counts and size more accurately compared with heparin under calcein-AM staining. PFP centrifuged at 16,000 × g for 15 min is sufficient to isolate MVs, which enables the batch processing of samples. PFP, rather than MVs alone, appears to be the preferable mode of sample storage, as MVs stored in PFP were less affected by storage temperature and duration. The present study provides a methodology for MV collection, storage and isolation, to facilitate further investigation of MVs as biomarkers in disease.

In this work, a novel electrochemical immunosensor for the detection of secretoneurin (SN), which uses metal ion functionalised reduced graphene oxide–tetraethylene pentamine (rGO–TEPA) as a label, is reported for the first time. rGO–TEPA contains a large number of amino groups, which makes it an ideal templet for the loading of metal ions. rGO–TEPA–Pb2+ was employed to immobilise secondary secretoneurin (SN) antibody (Ab2), and the resulting nanocomposite (Ab2–rGO–TEPA–Pb2+) was used as a trace tag for signal amplification. A modified electrode consisting of functionalised graphene nanosheets (Au@GS) was used as a substrate to immobilise the antibodies. Under the optimal conditions, the immunoassay exhibited high sensitivity, acceptable stability and reproducibility with a wide linear range from 0.001 to 100 ng mL−1 (R=0.996), and an ultra-low detection limit of 0.33 pg mL−1 (S/N=3). Furthermore, the immunosensor could be employed to detect SN in clinical serum samples. The proposed sensing strategy enriches the electrochemical immunoassay and exhibits potential for the point-of-care diagnostic application of the clinical screening of biomarkers.